Consejería de Sanidad y Dirección General de Estadística, Comunidad de Madrid, C/ Aduana 24, 28013 Madrid, Spain.
Unidad de Innovación, Instituto de Investigación Sanitaria San Carlos (IDISSC), Hospital Clínico San Carlos, C/ Profesor Martín Lagos, s/n, 28040 Madrid, Spain.
J Healthc Qual Res. 2022 Sep-Oct;37(5):275-282. doi: 10.1016/j.jhqr.2022.02.002. Epub 2022 Feb 25.
The first wave of the SARS-CoV-2 pandemic exerted enormous stress on the healthcare system. Community of Madrid hospitals responded by restructuring and scaling their capacity to adapt to the high demand for care.
This was a retrospective observational study conducted between 18 March and 21 June 2020 with data from public and private hospitals in CoM, Spain. Absolute and relative frequencies were calculated for inpatients with and without COVID-19, available and occupied beds in intensive care unit (ICU) and non-ICU wards, daily new admissions (NA), individuals awaiting hospitalisation in the emergency department (ED), and discharges.
Compared to pre-pandemic years, during the maximum care pressure period (18 March-17 April 2020), the average number of total available and occupied beds increased by 27% and 36%, respectively. Also, the average number of available and occupied ICU beds increased by 174% and 257% respectively, and average occupancy was 81%. The average daily NAs were 1,503 (90% from the ED) and 949 (63% due to COVID-19), and of these, 61 (6.4%) were admitted to the ICU. On average, at 6:00p.m., 1112 patients were waiting in the ED to be admitted and 299 (26.8%) patients waited for more than 24h. Discharges due to death for COVID-19 inpatients in the non-ICU and ICU wards were 16% and 36%, respectively.
This study confirmed the critical role of the ICU and ED, especially in the care of patients before being hospitalizated, in pandemic or health crisis scenarios.
SARS-CoV-2 大流行的第一波给医疗系统带来了巨大压力。马德里社区的医院通过重组和扩大其能力来适应对护理的高需求做出了回应。
这是一项回顾性观察研究，于 2020 年 3 月 18 日至 6 月 21 日在西班牙马德里社区的公立医院和私立医院进行，收集了有和没有 COVID-19 的住院患者、重症监护病房（ICU）和非 ICU 病房的可用和占用床位、每日新入院人数（NA）、在急诊室（ED）等待住院的患者和出院人数的数据。
与大流行前几年相比，在最大护理压力期间（2020 年 3 月 18 日至 4 月 17 日），总可用和占用床位的平均数量分别增加了 27%和 36%。此外，可用和占用 ICU 床位的平均数量分别增加了 174%和 257%，平均入住率为 81%。平均每日 NA 为 1503 例（90%来自 ED）和 949 例（63%因 COVID-19），其中 61 例（6.4%）被收入 ICU。平均而言，下午 6 点，有 1112 名患者在 ED 等待入院，其中 299 名（26.8%）患者等待超过 24 小时。非 ICU 和 ICU 病房 COVID-19 住院患者的死亡出院率分别为 16%和 36%。
本研究证实了 ICU 和 ED 的关键作用，特别是在大流行或卫生危机情况下对患者进行住院前的护理。
